Job Description

Become a part of our caring community and help us put health first

The Director, Home Health Risk Management identifies and analyzes potential sources of risk, proactively ensuring controls and processes are in place to reduce risk. The Director, Home Health Risk Management requires an in-depth understanding of how organization capabilities interrelate across the Home Health segment.

The Director of Risk Management for Home Health will be responsible for development and implementation of controls and cost-effective approaches to minimize risks to the organization as well as estimating the potential consequences of risks. Assesses and communicates information regarding business risks with functions across the organization. Their focus will be on CenterWell risk assessments, issue management, auditing and monitoring. Areas of oversight will include CenterWell Home Health, OneHome, as well as new growth initiatives.

This role requires an in-depth understanding of Home Health in a Value Based Care environment and how organization capabilities interrelate across segments and with the Plan side of Humana. This individual will be responsible for assessing and communicating information regarding business risks with functions across the organization at the Vice President level. Decisions are typically related to the implementation of new/updated programs or large-scale projects for CenterWell Home Health, supporting technical/operational procedures and processes, new regulatory or compliance regulation, evaluation and implementation of key controls, drives goals and objectives, improves performance, and provides input into strategy. This individual will lead a team of 5 total associates.

Use your skills to make an impact

Key Responsibilities:

• Focus on risk and compliance strategies for home health, telehealth, data privacy, and payor agnostic experiences.
• Payor contract compliance
• Oversees specialized proactive risk assessments for large financially impactful or business critical projects, business integrations as well as other risk tools such as lessons learned reviews.
• Partnerships across Integrated Health, Reporting, Marketing, and operational partners to ensure compliance with: Privacy, Security, and data sharing policies, Federal & State Laws, CHAPs certification requirements, and CMS regulations as applicable
• Establish an annual oversight workplan for areas of oversight (CenterWell Home Health & OneHome)
• Monitor teams progression to the workplan and ensure the quality of workplan items conducted by the team
• Issues management & resolution for areas of oversight, drive solutions to resolve issues
• Facilitation of discussions related to risk with AVP/VP level individuals
• Drive clear and open communication across the Home Health organization and key partners
• Continuously improve the Risk Management processes to enhance efficiency and effectiveness and reduce overall volume of issues
• Stay abreast of risk management trends and best practices within Humana and externally to incorporate better practices
• Partner with leaders across CenterWell to ensure consideration of regulatory guidance, patient, financial, and associate risks in key initiatives and decisions

• Facilitate conversations across Home Health leaders to drive resolution of issues and improvement of Quality
• Train team on risk management processes to enable them to be successful

Required Qualifications

• Bachelor's Degree
• 8 or more years of technical experience in the Home Health space
• 5 or more years of management experience
• Must be passionate about contributing to an organization focused on continuously improving consumer experiences

Preferred Qualifications

• Master's Degree
• 5 or more years of regulatory compliance or risk management experience

Additional Information:

Interview Format: As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Work at home requirements:

T o ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
Satellite, cellular and microwave connection can be used only if approved by leadership.
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.

SSN Alert:

Humana values personal identity protection. Please be aware that applicants may be asked to provide their Social Security Number, if it is not already on file. When required, an email will be sent from Humana@myworkday.com with instructions on how to add the information into your official application on Humana’s secure website.

Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.

$150,000 - $206,300 per year

This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance.

Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.

About us

About CenterWell Senior Primary Care: CenterWell Senior Primary Care provides proactive, preventive care to seniors, including wellness visits, physical exams, chronic condition management, screenings, minor injury treatment and more. Our unique care model focuses on personalized experiences, taking time to listen, learn and address the factors that impact patient well-being. Our integrated care teams, which include physicians, nurses, behavioral health specialists and more, spend up to 50 percent more time with patients, providing compassionate, personalized care that brings better health outcomes. We go beyond physical health by also addressing other factors that can impact a patient’s well-being.

About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first – for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.

Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.

Job Tags

Bi-weekly pay, Full time, Contract work, Temporary work, Apprenticeship, Work at office, Remote work, Work from home, Home office, Flexible hours,

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